Common baseball injuries and how to prevent them

When spring arrives, it means one thing for many athletes and fans: baseball season. However, daily practices, double-headers and tournaments that stretch across the weekend can take a toll on a young athlete's body. Kyle Utne, Physical Therapy Assistant at Children's Health℠ Andrews Institute for Orthopaedics & Sports Medicine and former baseball minor league athletic trainer, shares his insight on baseball injuries and ways players can stay healthy throughout the season.

What are the most common baseball injuries?

Some of the most common baseball injuries are overuse injuries. Baseball has transitioned from a spring and summer sport to a year-round marathon. Kids are participating in spring, summer and fall seasons with weekend long tournaments and showcases sprinkled in. One sport specialization provides little time off and can cause kids to miss out on the benefits of developing different fundamental movement patterns to become well rounded athletes. "The repetitive stress from throwing is a culprit for overuse injuries for any baseball player but especially for pitchers," says Utne. Recent data shows 250,000 youth are injured each year playing baseball.

Common types of overuse injuries in baseball

• Little League Shoulder – is an overuse injury caused by stress to the upper arm bone (humerus) nearest to the shoulder. Increases in stress can cause widening of the growth plate, resulting in inflammation and pain. If left untreated, further bone damage can develop such as a stress fracture. The good news is that little league shoulder will heal with several weeks of rest and a committed rehabilitation program.
• Rotator Cuff Injuries – the rotator cuff is a group of 4 muscles (supraspinatus, infraspinatus, teres minor and subscapularis) which together allow you to raise and rotate your arm. These muscles are an integral part of the throwing motion and repeated stress can lead to overuse tendonitis, impingement or even tears if left untreated.
• Little League Elbow – is an overuse injury caused by stress to the medial (inner) aspect of the elbow. Increases in stress can cause widening of the growth plate, resulting in inflammation, pain or a loss of range of motion. Little league elbow will heal with several weeks of rest and a committed rehabilitation program.
• Ulnar Collateral Ligament Injury – is a small ligament on the inner aspect of your elbow that provides stability during the throwing motion. Injury to the UCL has gained significant attention with the famous "Tommy John Surgery" over the last several years. Players between the ages of 15 and 19 account for nearly 57% of all Tommy John surgeries and increasing by an average of 6% per year, according to a 2015 study in the American Journal of Sports Medicine.

Other common types of injuries in baseball:

• Sprains and strains. Baseball players are susceptible to sprains to the arm, shoulder and elbow from pitching and throwing, and ankle sprains from base running.
• Fractures. Broken or fractured fingers, hands and wrists can be common among baseball players from impact with the ball, bases or other players, as well as from swinging the bat.
• Concussions. Catchers are most at-risk for suffering from a concussion.

Baseball players are also at risk of dehydration and suffering from the typical bumps, bruises and twists as other young athletes.

Fatigue is a common culprit for baseball injuries

"The number one indicator of all injuries is fatigue," shares Utne. "Parents know their children better than anyone else. Watching for warning signs of fatigue can help prevent serious baseball injuries that can result in time off or even surgery."

Fatigue can be caused by many factors, including:

• Playing year-round baseball
• Extended times of play, such as double-headers, long innings or tournament weekends
• High pitch counts and high leverage situations
• Playing on multiple teams at the same time
• Playing multiple games in a week with minimum days of rest
• Lack of sleep
• Poor diet
• Playing pitcher and catcher

Little League has set pitch count guidelines for different age groups under 16. "All coaches and parents need to be aware of these guidelines to make sure kids are not being over-utilized, especially when playing on multiple teams or participating in weekend-long tournaments," says Utne. Coaches and parents are responsible for making sure that athletes are not at risk for overuse injuries. These pitch counts do not include the warm-up throws before games, pitches between innings or the number of throws they take when playing a different position in the field, so awareness is key.

Fortunately, there are clear warning signs that coaches and parents can watch for that signal a player is getting fatigued, such as:

• Decreased Velocity
• Loss of proper mechanics like elbow height at foot contact
• Taking extra time between pitches
• Slower Reaction Time
• Decreased Performance
• Complaints of soreness or inability to get loose

How to reduce risk of baseball injury

"Proper preparation, training and recovery can go a long way in preventing injuries," says Utne. "Players, parents and coaches should work together and keep open lines of communication to share what's working, what's not and any concerns they may have."

Utne also suggests the following tips to keep young athletes healthy this baseball season:

• Fuel properly. Create a fueling program that gives players the energy they need. A sports dietitian can help athletes develop hydration and fueling strategies to meet the unique demands of practice and competition.
• Be aware. Make sure players know the difference between pain and soreness. "Generally, anything that lingers is a sign of injury," Utne explains. "If an athlete is still complaining of pain or soreness the next day, you should schedule an appointment to see a sports medicine provider."
• Prep for play. A proper warm-up before practice and games can help loosen muscles and reduce risk of injury. Players need to get their heart rates up and break a sweat with foam rolling, a lower body activation program, light jogging and a shoulder band routine.
• Cross-train. Training in other sports can also help reduce an athlete's risk of injury. "Playing other sports outside of baseball season teaches athletes important skill sets that advance their baseball play while giving them a chance to rest their arms and upper bodies," Utne adds.
• Awareness. Make sure players know the difference between pain and soreness. "Generally, anything that lingers is a sign of injury," Utne explains. "If an athlete is still complaining of pain or soreness the next day, you should schedule an appointment to see a sports medicine provider."

Learn more

The only pediatric institute of its kind in Texas, the Children's Health Andrews Institute for Orthopaedics and Sports Medicine aims at reducing the number of children being sidelined from injury. Learn more about our programs and services.